Fraga Sílvia, Lindert Jutta, Barros Henrique, Torres-González Francisco, Ioannidi-Kapolou Elisabeth, Melchiorre Maria Gabriella, Stankunas Mindaugas, Soares Joaquim F
Institute of Public Health, University of Porto, Porto, Portugal; Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal.
Department of Public Health Science, Protestant University of Applied Sciences, Ludwigsburg, Germany.
Prev Med. 2014 Apr;61:42-7. doi: 10.1016/j.ypmed.2014.01.008. Epub 2014 Jan 15.
To compare the prevalence of elder abuse using a multilevel approach that takes into account the characteristics of participants as well as socioeconomic indicators at city and country level.
In 2009, the project on abuse of elderly in Europe (ABUEL) was conducted in seven cities (Stuttgart, Germany; Ancona, Italy; Kaunas, Lithuania, Stockholm, Sweden; Porto, Portugal; Granada, Spain; Athens, Greece) comprising 4467 individuals aged 60-84 years. We used a 3-level hierarchical structure of data: 1) characteristics of participants; 2) mean of tertiary education of each city; and 3) country inequality indicator (Gini coefficient). Multilevel logistic regression was used and proportional changes in Intraclass Correlation Coefficient (ICC) were inspected to assert explained variance between models.
The prevalence of elder abuse showed large variations across sites. Adding tertiary education to the regression model reduced the country level variance for psychological abuse (ICC=3.4%), with no significant decrease in the explained variance for the other types of abuse. When the Gini coefficient was considered, the highest drop in ICC was observed for financial abuse (from 9.5% to 4.3%).
There is a societal and community level dimension that adds information to individual variability in explaining country differences in elder abuse, highlighting underlying socioeconomic inequalities leading to such behavior.
采用多层次方法比较老年人受虐待的发生率，该方法考虑了参与者的特征以及城市和国家层面的社会经济指标。
2009年，欧洲老年人受虐待问题项目（ABUEL）在七个城市开展，这些城市包括德国的斯图加特、意大利的安科纳、立陶宛的考纳斯、瑞典的斯德哥尔摩、葡萄牙的波尔图、西班牙的格拉纳达、希腊的雅典，涉及4467名年龄在60 - 84岁的个体。我们使用了一个三级层次数据结构：1）参与者的特征；2）每个城市高等教育的平均水平；3）国家不平等指标（基尼系数）。采用多层次逻辑回归，并检查组内相关系数（ICC）的比例变化，以确定模型之间的解释方差。
老年人受虐待的发生率在各地点之间存在很大差异。在回归模型中加入高等教育因素后，心理虐待的国家层面方差有所降低（ICC = 3.4%），而其他类型虐待的解释方差没有显著下降。当考虑基尼系数时，经济虐待的ICC下降幅度最大（从9.5%降至4.3%）。
在解释国家间老年人受虐待差异时，存在一个社会和社区层面的维度，它为个体差异增添了信息，突出了导致此类行为的潜在社会经济不平等。
